UW Today

August 17, 2011

Inside a UW Medicine O.R.: Robotic-assisted liver resection surgery

UW Health Sciences/UW Medicine

UW Medicine cancer surgeon Dr. James O. Park at the daVinci robot during surgery to remove diseased portions of his patient's liver.

Cheryl Colehour is the Seattle Cancer Care Alliance patient  who underwent the surgery. She  is a young mother and an instructional designer who had worked at the UW. The procedure removed parts of her liver affected by disease. She was discharged from UW Medical Center Aug. 15 and  is at home recovering. She thanked the surgical team for their efforts.

UW Medicine surgeon Dr. Ray Yeung at the liver resection surgery.

UW Medicine surgeon Dr. Ray Yeung at the liver resection surgery.Clare McLean

UW Medicine surgical oncologist Dr. James O. Park was assisted by a daVinci robot in peforming parts of the procedure. Robotic- assisted surgery helps overcome some of the limitations of laparoscopy. Traditional laparoscopy has  two-dimensional imaging and restricted instrument motion. Advanced computer-enhanced technology and robotic systems, like the daVinci,  have been developed to overcome those viewing and range-of-motion constraints.

Park said the surgery went well for their patient Aug. 11 ” thanks to the efforts of our A+ team.”  The members of the team were Dr. Youri Vater, anesthesiologist; Mike McMahon, operating room circulating nurse; Diane Buckley, Jan John and Yan Fu, all operating room scrub nurses, Holly Anderson,  a nurse who served as robot coordinator; and Dr. Ray Yeung, surgeon.

Members of the robot-assisted liver resection surgical team at work.

Members of the robot-assisted liver resection surgical team at work.Clare McLean

The first robotics-assisted liver resection at UW Medical Center  — and the first in the Pacific Northwest — was performed May 6, 2011. Since then a robotics-assisted biliary bypass was performed June 17, and another robotics-assisted liver-resection (the second at UW Medical Center) was performed July 18.

The Liver Tumor Clinic at UW Medical Center offers patients “one-stop” consultations with a team of specialists in the prevention, diagnosis and treatment of malignant and benign liver tumors. Physicians at the multidisciplinary clinic include specialists in interventional radiology, diagnostics, surgical oncology, pathology, hepatology, transplant services and medical oncology.

The Liver Tumor Clinic provides prevention, diagnosis and treatment of liver cancer, including that originating in the liver or as a secondary condition from another type of cancer. It has state-of-the art imaging and pathologic analysis, and provides a spectrum of treatment options. Patients also have the opportunity to choose to participate in clinical trials for which they might qualify.

Among the treatments provided to patients diagnosed with liver cancer. depedning on their individual case, are: liver transplantation, lapaparoscopic or open surgical removal of cancerous tissue from the liver, laparoscopic and percutanous radiofrequency ablation, chemoembolization, radioembolization, systemic chemotherapy, and microwave ablation.

Among the many strengths of the UW Liver Tumor Clinic is the diagnosis and treatment of hepatocellular carcinoma,  the eighth most common cause of cancer deaths in American men. The  clinic treats about 200 cases of this cancer a year. UW physicians’ experience with this large number of cases correlates to better outcomes for their patients.

This form of  liver cancer is becoming increasingly common in the United State, because of the rise in chronic hepatitis C infections. Other risk factors are a history of hepatitis B infection, heavy consumption of alcohol, iron overload, and non-alcoholic steatohepatitis (NASH).

Every year one to four percent of patients with cirrhosis — a fibrous scarring of the liver — develop this form of cancer. Early diagnosis and treatment  improves the odds of long-term survival.

The general contact number for the Liver Tumor Clinic  at UW Medical Center is 206.598.0539.